How Doughnut Bribes Helped Build America’s Opioid Addiction

October 05, 2016

Story at-a-glance

The U.S. spends more than $51 billion annually on the war on drugs. In 2014, more than 1.5 million arrests for drug-related violations were made, 83 percent of which were for possession only

No real effort is put into minimizing the availability of opioids. Perhaps worst of all, no consideration is given to alternatives that are FAR safer and just as effective; marijuana being one of them

The DEA recently announced its intent to move the herb kratom into a Schedule I controlled substance. Many use the herb to wean off opioids and relieve pain in lieu of these potent and addictive drugs

By Dr. Mercola

Drug addiction has reached unprecedented levels in the United States. Each year, the U.S. spends more than $51 billion on the war on drugs and, in 2014, more than 1.5 million arrests for drug-related violations were made.1 Of those arrests, 83 percent were for possession only.

The vast majority of drug-related arrests are for marijuana, and 88 percent of those are for possession only. Amazingly, 1 in every 111 adults in the U.S. is incarcerated (the highest incarceration rate in the world).

While nearly half of all U.S. states now allow the medical use of marijuana,2 and 20 have decriminalized marijuana possession and use, the federal government still classifies marijuana as a Schedule 1 controlled substance3,4 — a category reserved for the most addictive and dangerous of drugs, including heroin and LSD.

According to the 1970 Controlled Substances Act, Schedule 1 drugs are defined as those having a "high potential for abuse" and "no acceptable medical use in treatment."

Yet the Department of Health and Human Services (HHS) has held a patent for marijuana as a "neural protectant," claiming it can protect your brain against stroke and trauma, since 2003.5

The War on Drugs Is an Utter Failure

The illogical and hypocritical stance on marijuana is but one way the U.S. Drug Enforcement Agency (DEA) does more harm than good.

Considering the vast majority of drug-related arrests and convictions are for cannabis possession and use, the DEA is acting as a "head hunter" to fill up privately owned prisons with non-violent ganja users, who may or may not be using it for valid medicinal purposes.

Whether used for medical purposes or recreation, marijuana is nowhere near as dangerous as opioids, and addiction to prescription painkillers is spiraling out of control in this country. Yet when it comes to these profitable drugs, the DEA suddenly takes a whole different view on drug addiction.

Speaking about the heroin epidemic at a meeting in Cleveland, Ohio, (see video above) DEA chief Chuck Rosenberg stated we cannot "prosecute or enforce our way out of this mess." Instead, we need to "do a much better job of getting the word out about how dangerous this stuff is."

DEA Is Biased in Its War On Drugs

So in Rosenberg's (and the DEA's) view, marijuana users are criminals whom they have no qualms about prosecuting and jailing, but when a person is abusing opioid painkillers — from which drug companies profit handsomely — the answer is not criminalization but education. As reported by Cleveland.com:6

"Rosenberg was in Cleveland as his agency is working in tandem with the U.S. Justice Department in launching a multi-faceted effort in treating the overdose epidemic by partnering with local hospitals, rehabilitation clinics and educators to try and inform the public about cutting down on the use of prescription painkillers.

Rosenberg said the agency is also urging doctors across the country to cut down on prescribing unnecessary painkillers to patients, who sometimes end up addicted to the drugs or turn to more dangerous forms of opioids, such as heroin, once their prescriptions end."

I do not support criminalizing opioid addiction, but it is hypocritical in the extreme to fill for-profit jail cells with marijuana users while saying the same "cannot" work for prescription drug addicts. As noted by Opensecrets.org:7

"The revenue from waging the war on drugs has become a significant source of financial support for local law enforcement.

Federal and state funding of the drug war — as well as the property police forces seize as a part of drug raids — have become significant financial supplements to local forces' budgets …

One of the largest for-profit prison companies, Corrections Corporation of America [CCA], even stated in a regulatory filing that keeping the drug war alive is essential to its success as a business …"

Why DEA Won't Go After Corporate Drug Pushers

It's blatantly clear that the DEA does not want to criminalize prescription drug abuse because that would sorely hamper drug companies' ability to promote and sell painkillers. And that's really where the parties responsible for the current epidemic of addiction can be found.

Is it any surprise then that, in April 2016, a law was passed that restricts the DEA's ability to track and charge pharmacies and wholesalers who are expanding the epidemic? Andre Kolodny, director of Physicians for Responsible Opioid Prescribing, and an addiction specialist, responded to this news saying:8

"I'm shocked that Congress and the president would constrain DEA from taking on corporate drug dealers in the midst of the worst addiction epidemic in U.S. history. This law allows opioid distributors to reap enormous profits and operate with impunity at the public's expense."

The New Face of Heroin Addiction

Many patients are shocked and surprised to find themselves hooked on opioids after filling a prescription for something simple as a wisdom tooth extraction, sports injury or bout of back pain.

They were not properly warned and educated on how to safely take these drugs, and that stems from drug companies' deceptive marketing campaigns.

Once their prescription runs out, or can no longer satisfy their habit of use, many end up turning to heroin dealers. It's cheaper, and works just the same. The video above is just one example of how painkillers end up feeding a longstanding cycle of addiction.9

In August, Cuyahoga County in Ohio had 52 opioid-related deaths. So far this year, the county has recorded more than 500 overdose deaths — more than double that of 2015. Many of these deaths are attributed to street heroin cut with the drug carfentanil, a sedative for large animals like elephants.

Carfentanil is anywhere from 2,500 to 5,000 times more potent than heroin. The drug is so potent it even poses a lethal risk to first responders, should they inhale or absorb a tiny amount while working on the overdose victim. The following graph illustrates opioid overdose deaths by state.

Today, prescriptions of Oxycontin and other painkillers are the primary gateway drugs to heroin and other illicit drugs, and narcotic pain relievers are a primary culprit in opioid overdose deaths. As shown in the graph above, they cause FAR more deaths than heroin. The graphs below offer additional statistics, showing the true scope of the opioid problem.

Doctors are the new drug dealers. Respectable and legal, prescription drugs have an air of safety around them. But they are really no different from heroin. The documentary below details the tragic fate of several young people whose heroin addiction began with a legal prescription and ended in death.

Tech Competition to Combat Heroin Overdoses

In related news, the U.S. Food and Drug Administration recently launched "The 2016 Naloxone App Competition."10 The idea is to create a smartphone app to combat opioid overdoses. Tech wizards have until November 7, 2016, to submit their apps. As explained by CNN:11

"The FDA envisions an app that will connect anyone experiencing an opioid overdose with the closest supply of naloxone, a reversal drug.

Naloxone counteracts the effects of heroin, some addictive painkillers and the synthetic opioid fentanyl and is available at pharmacies with a prescription. It is often carried by medical and law enforcement first responders in most states as well as at-risk opioid users and family members. The app is intended to alert these antidote carriers when someone overdoses …

'With a dramatic increase in the number of opioid overdose deaths in the US, there's a vital need to harness the power of new technologies to quickly and effectively link individuals experiencing an overdose ... with someone who carries and can administer the life-saving medication,' FDA Commissioner Dr. Robert Califf said in the announcement."

Again, while the thought is good, the FDA, like the DEA, is missing the mark by ignoring the SOURCE of the problem, which is prescription opioids. Gently asking doctors to ease up on prescriptions is not enough. We don't need to incarcerate opioid addicts any more than we need to incarcerate marijuana users, but we do need to hold drug companies legally responsible for their products and the deceptive marketing practices that allowed this epidemic to swell out of control.

Opioid Epidemic Is an Undeclared Public Health Emergency

As noted in a recent STAT News article,12 the opioid epidemic really should be declared a public health emergency in order to mobilize the needed resources to address the situation.

"Congress took a first step toward responding to this expanding epidemic by passing, nearly unanimously, the Comprehensive Addiction and Recovery Act13 this summer. This $181 million act was designed to fund a wide range of activities essential to turning the tide on opioid addiction, including expansion of overdose reversal, recovery and prevention programs …

But since the Comprehensive Addiction and Recovery Act became the law of the land, Congress hasn't made any money available to turn it into real treatments for real people. Lawmakers looked good by approving the act, but … they never appropriated the money to fund it, rendering the bill and its good intentions effectively useless."

State of the Union

So what do we have here? We have a DEA that criminalizes marijuana — an effective and safe alternative to addictive and deadly opioid painkillers — and has repeatedly obstructed marijuana rescheduling efforts,14 thereby assuring the continued profitability of law enforcement and private prisons.15

Also, while Rosenberg has stated that "no drug product made from marijuana has yet been shown to be safe and effective," going so far as to refer to the concept of medical marijuana as "a joke," two synthetic tetrahydrocannabinols (THC) medicines — Marinol and Cesamer — recently received FDA approval for sale as patented drugs.

THC is a subclass of cannabinoids, the general category of active chemical compounds found in marijuana. Cannabidiols (CBD) is another subclass.16 Some cannabinoids are psychoactive, whereas others are not. THC is the most psychoactive, the one that produces the "high" associated with smoking pot.

Cannabinoids produce biological effects because, just like opiates interacting with your opiate receptors, cannabinoids interact with specific receptors located in your cell membranes. The approval of these drugs alone should be sufficient to prove marijuana has medical applications.

We have a Congress that supports the epidemic by legally restricting the DEA's ability to pursue corporate drug dealers. Moreover, former DEA chief Michele Leonhart 17 was harshly criticized for opposing the legalization of marijuana — so much so, President Obama was petitioned18 to have her removed for her anti-marijuana stance. Yet her replacement, Rosenberg, is following in the exact same footsteps!19

We have the FDA searching for high-tech solutions to get the overdose-reversal drug Narcan20 (naloxone) into the hands of drug addicts while approving more addictive painkillers. In 2013, the FDA issued a strong warning against the use of opioids to control pain. On the very same day, the agency approved Zohydro, a drug that has five to 10 times the potential for abuse. Two years later, the FDA approved the use of opioids in children as young as 11!21

Of course, on both ends of the epidemic, we have drug companies cashing in. In 2012, $9.38 billion worth of painkillers were sold in the U.S. OxyContin alone accounted for $2.81 billion in sales.22 Meanwhile, that same year, Amphastar Pharmaceuticals (the sole maker of the nasal-spray Narcan), began what appears to be a clear case of price gouging, raising its prices by as much as 100 percent.

Protecting Opioid Profits by Banning Herbal Alternatives

It appears no serious efforts are really being made on the behalf of the federal government to crack down on deceptive and manipulative drug company marketing. No real effort is put into minimizing the availability of opioids. Perhaps worst of all, no consideration is given to alternatives that are FAR safer and just as effective; marijuana being one of them.

Were marijuana decriminalized nationwide, the drug industry clearly would take a big hit. Not only would people have access to a far less expensive, more effective and natural version of synthetic THC drugs selling at a premium, many would also turn to marijuana to relieve their aches, pains, nausea, sleep problems, anxiety, depression and even cancer instead of using opioids and other expensive and potentially dangerous drugs.

No wonder drug companies are fighting to shut down the legalization of marijuana in order to maintain their drug monopoly. What's reprehensible is that the U.S. government is siding with the drug industry rather than doing what is best for the public health.

DEA Criminalizes Pain Relieving Herbal Tea

Besides marijuana, the DEA recently cracked down on the herb kratom, which is related to the coffee plant. The herb has garnered a loyal underground following of people using it to wean off opioids and relieve pain in lieu of these potent and addictive drugs. In late August, the DEA announced a plan to place kratom into a Schedule I controlled substance category, the same category as marijuana. Kratom users are incensed, and for good reason. As reported by Kaiser Health News:23

"In a YouTube video, a veteran shakes a bottle he says contains prescription opioids he has been given for pain. 'This,' he says, 'is not Schedule I.' 'Do I seem angry?' he continues, 'Yes. Because you're taking away a right that I fought for.

When I did my tour in Iraq, I fought for my right to be in America and be able to help myself, to cure myself. I'm not talking about snorting cocaine, shooting up heroin, I'm not even talking about puffing a joint. I'm talking about brewing some tea leaves, having a sip and feeling better' … People have uploaded hundreds of videos talking about why they drink or swallow kratom pills — veterans coping with PTSD, recovering alcoholics [and] people with fibromyalgia."

A WhiteHouse.gov petition24 to maintain kratom's legal status has nearly 137,000 signatures as of this writing. The DEA has also received an "unexpected" number of phone calls from people opposing the Schedule I classification. According to DEA spokesman Melving Patterson, the reason for the strict classification is "concern for public safety," as 660 calls to poison control centers involving kratom were received between January 2010 and December 2015.

Fifteen deaths between 2014 and 2016 have also been attributed to kratom (although kratom defenders are quick to point out that these deaths were the result of mixing the herb with other drugs).25 The DEA's justification is about as illogical as it gets. About 14,000 Americans died from overdosing on prescription opioids in 2014.26 Yet agencies like the DEA, FDA and HHS are fighting against marijuana and kratom!

How can seven or eight deaths a year compare to the tragedy of losing 14,000? While every death is tragic, when you're talking about public health, wouldn't it make sense to opt for the lesser evil or, in this case, the substance that causes the LEAST amount of harm? The hypocritical nature of this state of affairs is a clear sign that these federal agencies have ceased working for the public good.

The classification is also frustrating to researchers who believe, from initial testing prior to the ruling by the DEA, that kratom may hold the key to a non-addictive painkiller or even a route for treating addiction. They found the ingredients activated just the pain relief receptors and not the secondary receptors responsible for the deadly side effects from opioids, such as respiratory depression.27

Although also addictive in nature, kratom effectively treats withdrawal symptoms from heroin without life-threatening side effects, and has been useful in treating chronic pain without the potentially lethal effects of opioid overdoses.28 Side effects include headache and nausea.29

The Making of a Blockbuster Drug

Use of the opioid prescription painkiller OxyContin has been a primary driving force behind the addiction epidemic.30 The maker of OxyContin, Purdue Pharmaceuticals, manufactured the demand for the drug, and the epidemic, by falsely claiming the risk of addiction was "extremely small,"31 and/or had less potential for abuse compared to short-acting opioids.

Both claims are false. In a recent STAT News report,32 David Armstrong also reveals the role the global healthcare company Abbott Laboratories played in creating a demand for this dangerous drug.

"The pharmaceutical sales representatives from … Abbott Laboratories had a problem," Armstrong writes. "No matter what they tried, they couldn't get the attention of an orthopedic surgeon to convince him to prescribe the potent painkiller OxyContin … That is, until the staff let them in on a secret: 'We were told by his nurses and office staff that the best way to capture his attention and develop our relationship was through junk food,' the sales reps wrote in an internal memo.

The next week, one of the Abbott representatives showed up with a sheet cake box filled with doughnuts and snack cakes arranged to spell out the word 'OxyContin.' The gambit worked.

The surgeon listened to the sales talk, and every week after that, the Abbott sales personnel visited the doctor to ask him to switch at least three patients to OxyContin from other painkillers. The doughnut ploy, highlighted in a trove of internal documents obtained by STAT, shows the lengths to which Abbott went to hook in doctors and make OxyContin a billion-dollar blockbuster …

Purdue Pharma LP, the Connecticut company that developed OxyContin, has been vilified for planting the seeds of today's opioid crisis … But the role of Abbott in pushing the drug has largely escaped notice. The documents reveal it was a crucial partner in the aggressive — and misleading — selling of OxyContin during its first decade on the market."

Doctors Are Easily and Often Manipulated

The documents, which were part of a legal case brought by West Virginia against Purdue and Abbott for the inappropriate marketing of OxyContin, reveal Abbott's drug representatives were clearly instructed to downplay the risk of addiction. They were also taught to make other claims "that had no scientific basis," Armstrong writes.

Purdue even agreed to indemnify Abbott from any legal expenses associated with its efforts to sell the drug — that's how important a role Abbott Labs played in Purdue's scheme.

Aside from the occasional doughnut ploy — which actually won the Abbot sales rep in question the "best OxyContin sales success story" award — Abbott's drug reps also used techniques such as taking doctors to their favorite takeout restaurant or bookstore, where they would "detail" the doctor — i.e., present the selling points of the drug — while waiting to pay.

Bringing lunches, cookies or snacks are also common strategies aimed at getting on the good side of doctors, nurses and other personnel that might influence a doctor's prescription habits. Then there were the business strategies aimed at the sales force itself. Armstrong writes:

Their almost religious zeal to sell the drug is evident in the wide use of terminology from the Middle Ages Crusades: Sales reps were called 'royal crusaders' and 'knights' in internal documents, and they were supervised by the 'Royal Court of OxyContin' — executives referred to in memos as the 'Wizard of OxyContin,' 'Supreme Sovereign of Pain Management' and the 'Empress of Analgesia.'"

The head of pain care sales, Jerry Eichhorn, was the 'King of Pain' and signed memos simply as 'King.' 'As you continue to carry the OxyContin banner onto the field of battle, it's important to keep highlighting OxyContin benefits to your doctors,' Abbott urged its sales staff in a memo contained in the court records.'"

Treating Pain Without Drugs

Considering the risks, I would urge you to consider other options before resorting to an opioid painkiller. It's especially important to avoid opioids when trying to address long-term chronic pain, as your body builds a tolerance to the drug. Over time, you'll require greater doses at more frequent intervals to achieve the same pain relief, which is a recipe for disaster and could have lethal consequences.

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